mahmoud nateghi rostami

Sharp injuries are known as one of the hazards of Health Care workers. This study was designed to determine the epidemiology of sharp injuries of staffs in the Qom province.

This is a descriptive-analytical and retrospective study which is done on the sharp injuries patients files in the last three years in Qom province. Statistical analysis of data was performed by using SPSS software (Ver. 22).k2, t-test and Fisher’s exact tests were used to compare groups.

Totally 100 subjects (59 female and 49 men) who had a history of injuries accident were included from Qom provinces’ hospitals. The mean age of the subjects was 42±6.4 years and the frequency of those over 30 years was significantly higher than other age groups (P<0.05). The highest percentage of injuries was related to nurses and paramedics with 47% and the lowest rate to physicians (15%) (P<0.05); most of them were working at nights (57%) in surgery (21%) and emergency (20%) units. Syringe (51%) and suture (42%) needles were responsible for most of the injuries (P<0.05). Most of subjects were negative for viral infections tests, but 28% of them were HBs Ag positive. Other laboratory tests were also negative for the affected subjects.

As sharp injuries especially in the night shifts might have a role in the transfer of blood burn infections including Hepatitis viruses, it is necessary to recognize sharp injuries as a major occupational hazard, especially for health care staff, and accidents should be included in surveillance programs

The outcome of Leishmania infection mainly depends upon the Leishmania species which causes the disease and the generation of the type of host immune response, the healing process and protection in leishmaniasis depends upon induction of Th1 response. In this study, the Th1/Th2 cytokine profile in cutaneous leishmaniasis (CL) is evaluated.

This study was carried out in leishmaniasis clinic of CRTSDL, TUMS, during March 2018 to March 2019. Peripheral blood mononuclear cells (PBMC) of volunteers with active healing and non-healing lesion (s) of cutaneous leishmaniasis (CL), volunteers with and without history of CL were cultured and stimulated with Soluble Leishmania antigen (SLA). The supernatants were collected and the levels of IFN-γ, IL-5 and IL-10 were titrated using ELISA method.

The results showed a significantly higher levels of IFN-γ in volunteers with active CL healing form (p<0.005), history of CL (p<0.005) than healthy volunteers. A significantly (p<0.005) higher level of IFN-γ was seen in volunteers with active healing form of lesion than non-healing form. There was a significantly (p<0.005) higher level of IL-10 in volunteers with a history of non-healing form and active non-healing form of CL. There was no significant difference in IL-5 production in PBMC of different groups.

IFN-γ production starts at early stage of cutaneous leishmaniasis and enhance during course of lesion healing, IFN-γ level is significantly higher in all patients compared to healthy volunteers, IFN-γ is significantly higher in patients with healing form than non-healing form of lesion.

 The hospital environment usually involves in cross-colonization and/or outbreaks of carbapenem-resistant Acinetobacter baumannii (CRAB). This study aims to identify genetic diversity of environmental Acinetobacter baumannii (A. baumannii) isolates based on OXA-type carbapenems.

 It was intended to identify the environmental source of A. baumannii strains to control future infections and ongoing outbreaks.

 Swab samples were collected from equipment, fluids and surfaces of intensive care units of five hospitals (H1 to H5). The susceptibility of the isolates was defined through disk diffusion method. blaOXA-51, blaOXA-58, blaOXA-23, and blaOXA-24 genes were detected by multiplex polymerase chain reaction (PCR) . Genetic diversity was investigated using ERIC-PCR. Mean values were compared using an Independent samples t-test.

 The mean number of Gram-negative bacilli colony per sample was significantly higher in moist surfaces (1.9 ± 2.37) than in dry surfaces and medical equipment (P < 0.05). Among 32 A. baumannii isolates, 17 (53.1%) were classified as CRAB, 13 (40.6%) as multidrug resistant (MDR) and six (18.8%) as extremely drug resistant (XDR) phenotypes. The isolates showed the most susceptibility to tigecycline (81.3%) and doxycycline (81.3%). Totally, 10 isolates (31.3%) carried blaOXA-23 and one isolate carried blaOXA-58, but none contained blaOXA-24. Typing of the strains provided seven single types (ST) and nine clusters (A-I). Two isolates in cluster B (different surfaces of H4) and two in cluster I (from ventilators of H3 and H1) were designated as common type (CT). In H4 and H1, different isolates belonging to different clusters were recovered from bed sheet and baby sink bath, respectively.

 Clonally-related blaOXA-23 positive CRABs occurred in the environment, especially on moist surfaces of hospitals. The distribution of the same clones in different hospitals may point to expansion of a specific clone which increases the risk of cross-colonization of vulnerable patients.

Carbapenem-resistant Pseudomonas aeruginosa has emerged as a serious problem in many hospitals and intensive care units. The purpose of this study was to determine the antibiotic susceptibility profile and the distribution of metallo-beta-lactamase genes among P. aeruginosa isolates from Qom province of Iran.

In this study, 200 P. aeruginosa isolates were collected from several clinical samples in hospitals affiliated to Qom University of Medical Sciences, Qom province, Iran. The antibiotic susceptibility of the isolates was tested by the Kirby-Bauer disc diffusion test and the distribution of MBL genes among carbapenem-resistant isolates was determined by polymerase chain reaction (PCR) method.

Among carbapenem non-susceptible isolates of P. aeruginosa, 38% (76 isolates) were multidrug resistant, 26% (52 isolates) were pan-drug-resistant and 5% (10 isolates) were extensive drug resistant. 52% of the isolates were resistant to carbapenems. Among carbapenem non-susceptible isolates of P. aeruginosa, 40 isolates (38.4%) exhibited MBL production. Of 40 MBL-producing isolates, 38 isolates (36.5%) contained the blaIMP gene and two (1.9%) isolates contained the blaVIM gene.

Outbreaks of MBL-producing P. aeruginosa isolates will be a serious problem in hospitals in the future and rapid identification of these isolates is necessary to control further dissemination of MBL resistance genes. This is the first report of the rates of MDR, XDR, PDR, and MBL-producing P. aeruginosa isolated from hospitals affiliated to Qom University of Medical Sciences in Qom province of Iran

Antibiotic resistance in Acinetobacter baumannii and outbreaks caused by this organism have been reported from several areas of the world. The present study aimed at determining the antibiotic susceptibility profiles and the distribution of OXA-type beta-lactamases among Iranian Acinetobacter baumannii isolates from Qom of Iran.
For this study, 108 non-duplicate A. baumannii isolates were obtained from clinical specimens in four teaching hospitals in Qom in the central of Iran. The antimicrobial susceptibility of isolates was tested by standard disk diffusion and prevalence of bla OXA genes was investigated by PCR method.
Among 97 carbapenem non-susceptible isolates of A. baumannii, 90.72% (88 isolates) isolates showed extensive drug resistance to multiple antibiotics. Among carbapenem resistant isolates, 100% carried blaOXA-51-like, 82.47% carried blaOXA-23-like, 55.67% carried blaOXA-58-like, 22.68% carried blaOXA-40-like and 14.43% had blaOXA-143-like resistance genes.
This study demonstrated high genetic diversity of OXA genes among isolates of A. baumannii in Qom, Iran.

Chlamydia trachomatis is the most common sexually transmitted bacterial pathogen worldwide. Early detection and treatment of C.trachomatis genital infection prevent serious reproductive complications.

Performances of enzyme immunoassay (EIA) and major outer membrane protein (MOMP)-polymerase chain reaction (PCR) for diagnosis of genital C.trachomatis infection in women were compared.

In this cross sectional study a total of 518 women volunteers were included (33.67±8.3 yrs) who had been referred to Gynecology clinics of Qom province, Iran, were included. Endocervical swab specimens were collected to detect lipopolysaccharide (LPS) antigen in EIA and to amplify MOMP gene of C.trachomatis in PCR. Results were confirmed using ompI nested-PCR. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) were calculated for performance of the tests. Odds ratios were determined using binary logistic regression analysis.

In total, 37 (7.14%) cases were positive by EIA and/or MOMP-PCR. All discrepant results were confirmed by nested-PCR. Sensitivity, specificity, PPV and NPV values of EIA were 59.46%, 100%, 100% and 96.98%, and those of MOMP-PCR were 97.30%, 100%, 100%, 99.79%, respectively. Reproductive complications including 2.7% ectopic pregnancy, 5.4% stillbirth, 5.4% infertility, and 10.8% PROM were recorded. The risk of developing chlamydiosis was increased 4.8-fold in volunteers with cervicitis (p

C.trachomatis infection should be regarded in women of reproductive ages especially those with cervicitis. Primary screening of women by using the low cost antigen-EIA is recommended; however, due to the low sensitivity of Ag-EIA, verification of the negative results by a DNA amplification method is needed.

The role of the hospital environment as a source of dissemination of pathogens is critical. Environmental surfaces in the Intensive Care Units (ICUs) are suitable for the growth of Gram-negative bacteria that normally circulate between the environment and patients and can cause outbreaks of nosocomial infections. In this study, the prevalence of Gram-negative bacilli in the environment of the ICUs and neonatal ICU (NICU) of hospitals in the city of Qom was evaluated.
During a 6 month period from November 2012 to April 2013, samples were collected from environmental surfaces of ICUs of four hospitals and NICU of one hospital located in the city of Qom. Sampling was done from equipment, fluids, and surfaces and identification was carried out based on culture and biochemical tests for Gram-negative bacilli.
A total of 230 swab samples was collected and 50 colonies of Gram-negative bacilli were isolated from environmental surfaces. Overall, 64% of the isolates belonged to non-fermentative bacteria and 36% of the isolates belonged to Enterobacteriaceae family. Strains of Pseudomonas aeruginosa and Acinetobacter baumannii complex accounted for the highest rates of environmental isolates. In addition, Klebsiella pneumoniae was isolated from NICU.
The high frequency of genus Acinetobacter among Gram negative bacteria isolated from environmental surfaces has a public health impact and Acinetobacter spp. should be considered in the infection control programs in hospitals. Isolation of K. pneumoniae should be regarded as a risk factor for fatal neonatal infections.

Trichomonas vaginalis infection is one of the most common sexually transmitted diseases of women and men in the world. To the best of our knowledge, there has been no previous report of the prevalence and complications of trichomoniasis in women of Qom.
In this cross-sectional study, the prevalence of T. vaginalis in women whom were admitted to a referral gynecology clinic in the city of Qom. For this purpose, two diagnostic methods, wet mount and ITS-PCR, were used to examin the vaginal swabs taken from the participants. Microscopic examination of cellular morphology and bacteria was also conducted on the stained smear.
Three hundered volunteers were enrolled. Of 300 specimens, 7 (2.67%) by wet mount and 34 (11.3%) by ITS-PCR method were positive. The positive results of ITS-PCR were confirmed by sequencing of PCR products. In comparison with women without T. vaginalis infection, infection with T. vaginalis was associated with increased the risks of low birth weight (OR=43.3; 95% CI=2.8-671.9), in women with history of abortion (OR=91.8; 95% CI=15.5-544.2), and in women with premature rupture of membrane (PROM) (OR=21.6; 95% CI=2.1-22.9). Probability of finding of epithelial cells (OR=36.9; 95% CI=6.9-197.3) and white blood cells (OR=43.3; 95% CI=2.8-665.1) in stained smear were higher in women with T. vaginalis compared to those without T. vaginalis.
Comparing with wet mount, ITS-PCR seems to be a more sensitive and reliable technique in detection of T. vaginalis infection in women. The high prevalence of trichomoniasis emphasizes the need for screening of women in Qom. Early examination and accurate diagnosis of T. vaginalis, especially in middle-aged women, could prevent pregnancy-related complications of T. vaginalis.

Leishmanization (LZ) is an effective tool to prevent cutaneous leishmaniasis. Standardization of Leishmania is the main drawback of LZ. The aim of this study was to assess the effect of various preservatives on the infectivity of Leishmania. L. major harvested at different stages of growth; logarithmic, early and late stationary phases were frozen using various preservatives of saccharose, glycerol, trehalose, glucose, sorbitol, and dimethyl sulfoxide (DMSO). The harvested parasites were inoculated into BALB/c mice before and after freezing. The infectivity of the parasites was checked. IFA test was used to assess the rate of metacyclic parasite. The ratio of live Leishmania in different growth stages and various preservatives were 89.0% to 98.2%. The lesion development in groups of mice which received Leishmania in sacarose + glycerol or DMSO was started from 3rd week and at 5th week all the mice showed lesion. The group of mice which were inoculated with early or late stationary phases in saccharose + glucose, saccharose + glycerol, glycerol 15% or DMSO showed lesion from 4th to 5th week and in 100% showed lesions at 8th week. The rate of metacyclic parasites increases from log phase to early and late stationary phases. There was a correlation between percent of live parasite and the rate of lesion development in BALB/c mice. Saccharose 22.5% + Glyserol 22.5% were the most appropriate preservative to freeze L. major. IFA test is used to detect metacyclic Leishmania. A correlation was seen between the rate of lesion development in BALB/c mice and IFA positivity.